GU Packet 4

Question 1

Define AKI/ARF

Answer 1

Sudden loss of kidney function

Question 2

What are the typical pathophysiological causes of ARF

Answer 2

reduced renal perfusion and acute tubular necrosis

Question 3

What are the 3 major causes of AKI/ARF

Answer 3

Prerenal disease (renal artery)
Renal disease (kidney itself)
Postrenal disease (ureter)

Question 4

How can the possible cause of AKI be identified?

Answer 4

medical history

Question 5

What are contributing factors to AKI

Answer 5

HTN
Hypotension
Volume loss
CHF
Diabetes

Question 6

What is key to measure renal function in AKI/ARF

Answer 6

GFR

Question 7

What test is unreliable in AKI/ARF

Answer 7

Serum BUN/Cr

Question 8

What may UA show in AKI/ARF

Answer 8

hyaline casts

Question 9

How is AKI/ARF treated

Answer 9

correcting underlying problem

Question 10

Define CKD

Answer 10

Progression of ongoing loss of kidney function (GFR)

Question 11

CKD criteria

Answer 11

GFR less than 60 mL/min or presence of kidney damage for more than 3 months

Question 12

How many stages of CKD

Answer 12

5, based on estimated GFR
1-3 are asymptomatic
4 - symptomatic
5 - ESRD
*also classified according to albuminuria status

Question 13

Risk factors for CKD

Answer 13

DM
HTN
CVD

Question 14

Causes of CKD

Answer 14

DM
HTN
GN

Question 15

What is the gold standard for testing for CKD

Answer 15

Measurement of GFR

Question 16

What is the treatment for CKD

Answer 16

aimed at slowing the progression of CKD and treating reversible causes of acute deterioration; ACE inhibitors and angiotensin receptor blockers

Question 17

What is the BEST treatment for CKD

Answer 17

Prevention

Question 18

What causes 80% of ESRD

Answer 18

DM, HTN or both

Question 19

What is the criteria for ESRD

Answer 19

GFR less than 15 mL/min

Question 20

Describe kidney function in ESRD

Answer 20

no longer adequate for long-term survival without kidney transplant or dialysis

Question 21

What is the best treatment option for ESRD

Answer 21

kidney transplant

Question 22

What is the other option for ESRD treatment

Answer 22

hemodialysis or peritoneal dialysis

Question 23

what are stones within the bladder called

Answer 23

vesical calculi or cystoliths

Question 24

What are urinary stones most commonly composed of

Answer 24

calcium oxalate

Question 25

What are the 3 risk factors for nephro/urolithiasis

Answer 25

Urinary composition
dietary
non-dietary

Question 26

What are the clinical features of urolithiasis

Answer 26

renal/ureteric colic usually associated with hematuria, urgency, frequency, N/V

Question 27

How does a pt present with urolithiasis

Answer 27

obvious pain and inability to get comfortable
ipsilateral tenderness

Question 28

What is the gold standard for identifying almost all stones

Answer 28

non-contrast abdominopelvic helical CT

Question 29

What is the imaging of choice for urolithiasis in pregnant women

Answer 29

US of kidney and bladder

Question 30

Intervention for stones >4mm

Answer 30

ureteroscopy removal
extracorporeal shock wave lithotripsy
percutaneous nephrolithotomy

Question 30

what is a complication of urolithiasis

Answer 30

obstruction and an upper UTI is a true urological emergency

Question 30

What is the acute management for urolithiasis <6mm

Answer 30

fluids
medical expulsion therapy w/ alpha blockers (tamsulosin)
pain management